ROESHAN SHADRAVAN (NPI# 1144860743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144860743 |
| Entity Type | Individual |
| Full Name | ROESHAN SHADRAVAN |
| Credential | DO DN DOMP |
| Practice Address |
1505 Lomas Santa Fe Dr Solana Beach CA 92075-2103 |
| Mailing Address |
307 Sanford St Encinitas CA 92024-1508 |
| Practice Telephone | 7602121678 |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2020-01-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | CA30079 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1505 LOMAS SANTA FE DR |
| City | SOLANA BEACH |
| State | CA |
| Zip Code | 92075-2103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669092490 | Tara Tryphena Steinke | Naturopath | 124 Lomas Santa Fe Dr Ste 20b, Encinitas, CA 92075 | 2020-04-22 |
| 1336782085 | Jeremy Tiefenbrun | Behavior Technician | 992 1 C Lomas Santa Fe Dr Pmb 291, Solana Beach, CA 92075 | 2019-10-25 |
| 1851827927 | Amelia Rose Clark | Physician Assistant | 437 S. Highway 101 Suite 217, Solana Beach, CA 92075 | 2017-05-10 |
| 1518348317 | Kelly Pounds | Counselor | 2101 East First Street, Santa Ana, CA 92075 | 2015-06-17 |
| 1295114908 | Synapse Hearing Health, Inc. | Audiologist | 991 Lomas Santa Fe Drive, Suite A, Solana Beach, CA 92075 | 2015-05-27 |
| 1619381464 | Michael David Leiderman | Community Health Worker | 309 N Solana Hills Drive Apt #95, Solana Beach, CA 92075 | 2014-06-19 |
| 1881932879 | Edward S. Loh | Urology | 775 Beachfront Dr., Solana Beach, CA 92075 | 2013-01-25 |
| 1093076135 | Jodi Lee Abramowitz | Psychologist | 115 W Plaza St Ste 200, Solana Beach, CA 92075 | 2012-06-05 |
| 1710297692 | Aliza Danielle Cicerone | Naturopath | 124 Lomas Santa Fe Drive, Suite 206, Solana Beach, CA 92075 | 2010-10-13 |
| 1518273309 | Martin Landau-north | Marriage & Family Therapist | 731 South Highway 101, Suite 2j, Solana Beach, CA 92075 | 2010-08-31 |
| Find all providers in zip 92075 | ||||
| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548722416 | R. Mitchell Hiserote Do, Professional Corporation | Neuromusculoskeletal Medicine & OMM | 7064 Corline Ct Ste C1, Sebastopol, CA 95472-4528 | 2019-04-01 |
| 1851768899 | Petaluma Acupuncture Center | Neuromusculoskeletal Medicine & OMM | 720 Southpoint Blvd Ste 211, Petaluma, CA 94954-7496 | 2015-08-25 |
| 1063800258 | Kulveen Sachdeva, Md Inc. | Neuromusculoskeletal Medicine & OMM | 5401 Norris Canyon Road, Suite 110, San Ramon, CA 94583-5402 | 2014-12-23 |
| 1982010559 | Walter Jaye Cohen | Neuromusculoskeletal Medicine & OMM | 3706 Ruffin Rd Ste 129, San Diego, CA 92123-1812 | 2014-07-03 |
| 1962815068 | Sunil Bhat | Neuromusculoskeletal Medicine & OMM | 2555 Flores St Ste 395, San Mateo, CA 94403-2344 | 2014-06-05 |
| 1417298811 | Sibyl Knight | Neuromusculoskeletal Medicine & OMM | 199 17th St Ste J, Pacific Grove, CA 93950 | 2013-03-09 |
| 1447597349 | Lee Ann Marie Cuny | Neuromusculoskeletal Medicine & OMM | 1502 Tennessee St, Vallejo, CA 94590-4627 | 2013-01-11 |
| 1285985820 | Annette Hulse | Neuromusculoskeletal Medicine & OMM | 1 1st St Ste 3, Los Altos, CA 94022-2753 | 2012-09-23 |
| 1871853796 | Brian Peternell | Neuromusculoskeletal Medicine & OMM | 584 35th Ave, Santa Cruz, CA 95062-5111 | 2012-05-24 |
| 1639455462 | Sanjay Chauhan Md Inc. | Neuromusculoskeletal Medicine & OMM | 2407 E Sussex Way Ste 107, Fresno, CA 93726-4035 | 2011-10-25 |
| Find all providers with the same taxonomy | ||||
| City | SOLANA BEACH |
| Zip Code | 92075 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.